无静脉吻合的末节断指再植36例

Replantation of the distal phalanx without venous anastomosis in 36 cases

目的 报道无静脉吻合的末节断指的再植方法.方法 2002年4月-2007年12月,36例42指无可供吻合静脉的末节断指采用扩髓及吻合双侧指掌侧动脉后,指根部结扎非优势侧指固有动脉手术方法,进行再植.评估手术效果.结果 再植指全部成活,随访6-24个月,按中华医学会手外科学会断指再植功能评定试用标准评定：优24例,良12例,等级评分＞78分.结论 对于无静脉可供吻合的末节断指,采用扩髓及吻合双侧指掌侧动脉后,指根部结扎非优势侧指固有动脉的手术方法,是一种可靠的再植技术.

Objective To report replantation of the distal phalanx without venous anastomosis. Methods From April 2002 to Decmber 2007, 42 completely amputated fingers in 36 patients were replanted in our center. Expansion of the medullary cavity was performed in all amputated parts. After anastomisis of both proper digital arteries, the small artery was ligated at the base of proximal phalanx. The survival and functional assessments were performed. Results All 42 digits survived. The follow-up period ranged from 6 to 24 months. According to the Chinese Medical Association Society standard for digital replantation assessment, there were excellent and good results in 24 and 12 digits, respectively. All digits scored above 78. Conclusion Replantation of the distal phalanx without venous anastomosis is a reliable technique.